How Not to Make a Documentary About Vaccines

A new documentary about Andrew Wakefield, the former
gastroenterologist and floppy-haired mascot of vaccine
skepticism, draws its title from a phrase Wakefield used to
describe himself. The film does not get much more critical from
here.

Andrew Wakefield is the lead author of a discredited 1998 study
that kicked off the modern anti-vaccine movement. The study suggested a connection
between the MMR (measles-mumps-rubella) vaccine and autism,
which he made explicit in a press
conference on the study’s findings, announcing that “I cannot
support the continued use of the three vaccines given
together.”

A 2004 investigation by the journalist Brian Deer in theSunday Timesmade the claim that
Wakefield had undisclosed conflicts of interest, and the study
was eventually retracted. After an investigation by the General
Medical Council in Britain, he was accused of “multiple
separate instances of professional misconduct” and exhibiting a
“callous disregard” for the suffering of the children involved
in his research, resulting in over 30 charges. In 2010, the
General Medical Council stripped Wakefield of his
medical license. Wakefield’s position is that this imbroglio
was a conspiracy to discredit him, and
continues to share his belief—despite an enormousbody of research demonstrating
otherwise—that the MMR vaccine causes autism. He has been
blamed for an uptick in measles infections in the U.K. and United States, where the
disease had previously been eradicated. Earlier this year, a
Somali immigrant community in Minnesota which Wakefield and
other anti-vaccine activists visited was the site of a measles outbreak.

The Pathological Optimist, directed by Miranda Bailey,
follows Wakefield and his family from 2011 to 2016 during his
attempts to sue the British Medical Journal, its
editor Fiona Godlee, and the journalist Brian Deer; they’d
published a 2011 investigation that claimed that the 1998Lancet study Wakefield co-authored was fraudulent,
featuring distorted data. Press
materials for The Pathological Optimist, which
premieres today,frame the film as a character
study that “takes no sides, instead letting Wakefield and the
battles he fought speak for themselves.”

“I said ‘listen, I’m not out there to prove that you’re right,
and I’m not out there to prove that you’re wrong,’” Bailey told
Jezebel in a phone interview, referencing an early conversation
she had with Wakefield. “‘I just want to watch, and see what
happens.’ And he was like ‘yeah, that’s fine.’”

Bailey, a film producer whose credits include The Diary of
a Teenage Girl, Lake Bell’s latest directorial effortI Do… Until I Don’t, and the Oscar-nominated The
Squid and the Whale, has not historically been silentabout vaccine safety. My
colleague Anna Merlan included Bailey in a 2015 list of
“anti-vaccination celebrities” because Bailey tweeted in
opposition to SB 277, a California law that removed personal
belief exemptions to vaccination requirements. SB 277 was apoint of contention for vaccine skeptics,
many of whom rigorously object, without evidence to back up
their position, to the concept of mandatory vaccination.
Anti-vaccine sentiment isn’t limited to Hollywood (Brooklyn
veterinarians recently noticed that some people are refusing to
vaccinate their pets, for example),
but a Pediatrics study found that parents skeptical of
vaccines are typically white and well-off.

Bailey told me that her tweets were “taken out of context,” and
that she believes the Hepatitis B vaccine should be
administered when children are older, not never at all. (The
Center for Disease Control disagrees.)

Image via Bailey’s Twitter

“I think that vaccines are an incredible, valuable tool; I want
them available for me and my children,” she told Jezebel. She
also says she thinks it would have been proven by now if the
MMR vaccine caused autism. “I would say I’m pro-vaccine, but I
think everybody’s pro-vaccine, because I mean, what, are people
pro-disease? No,” she said. In general, Bailey says she objects
to the label “anti-vaccine activist,” which she believes paints
with too broad a brush; she told me “vaccine hesitant” is a
better way to describe those individuals.

But back to the documentary. A character study on someone like
Andrew Wakefield might have made for a good one, but that’s not
really what The Pathological Optimist turned out to
be. Nearly everything Wakefield says or does in the film seems
constructed to convince viewers that he has been—as his wife
Carmel Wakefield puts it at one point—“gravely defamed.”
Although clips of Wakefield being criticized on TV appear
throughout the documentary, and notes flashed on the screen
provide counterpoints to certain claims, no one speaks directly
to the camera or appears to have been interviewed at all who
might give any sort of conflicting or complicating observation
about Wakefield’s scientific career or his treatment by the
press.

The only people who do speak directly to the camera are
Wakefield, his wife, one of his children, his brother, two of
his lawyers, a few fans at his book signing, and a supporter of
Wakefield’s who believes her son became autistic immediately
after receiving the MMR vaccine. Several of them take this
opportunity to question the integrity of the press, which seems
like it could undercut the authority of the aforementioned
critical press clips—particularly in an era when the media is
consistently held up as a singular and sinister establishment
force. Wakefield’s argument, after all, is that the media, the
medical establishment, the CDC—they’re one big, amorphous
“them,” all out to hide an inconvenient truth. (Here are the members of the
FDA’s Vaccines and Related Biological Products Advisory
Committee; the majority of them do not work for drug
companies.)

The film acknowledges that a huge amount of research has
shown no link between vaccines and autism, which begs the
question: why is the author of a debunked study being given a
90-minute opportunity to tell his side of the story, using a
unique strain of jargon-cluttered British
persuasiveness? It’s disingenuous to claim objectivity when
one side lacks a viable argument; to do so is to encourage a
sense of mystery and controversy around vaccine safety, which
belies the fact that among public health experts and clinicians
alike, this is not a topic of disagreement.

Vaxxed, an anti-vaccine film by Wakefield that
premiered while The Pathological Optimist was filming,did just this to try to
convince viewers that vaccines are controversial and
disputed—which they are, though not amongst those who actually
study them. Among Bailey’s many vaccine-related tweets is a
full-throated endorsement of the 2011
documentary The Greater Good, which the New York
Timesdescribed as an “emotionally
manipulative, heavily partial look at the purported link
between autism and childhood immunization” that benefits from
“appearing to present both sides of the debate.” And as we see
in the Hollywood Reporterreview of The
Pathological Optimist, it’s quite an effective way to sow
doubt, if that is something one wanted to do:

If you have any doubt that reviewing a documentary about
Andrew Wakefield, the British doctor who became the public
face of the anti-vaccination movement, is a difficult
proposition, scroll down. You’re bound to see a jampacked
comments section featuring incendiary remarks from readers
both pro and con on the subject. So, let me stipulate up
front that this reviewer is not taking a stand on the
controversial issue. Please forgo the invective, folks.

The film’s main antagonist, the British journalist Brian Deer,
was not interviewed for the film, even though his name is
mentioned throughout (at one point, a “Down with Deer!” cheers
takes place). Clips of him on TV appear instead, and it’s noted
at the end that Deer declined to participate in the
documentary, which Deer claims is not true.

(Wakefield previously sued Deer for
libel in the U.K. in 2005; he dropped the suit and paid the
defendants’ legal expenses shortly after the judge wrote anopinion concluding that
Wakefield “wished to extract whatever advantage he could from
the existence of the proceedings while not wishing to progress
them or to give the Defendants an opportunity of meeting the
claims.”)

When I initially reached out to Deer, he said he knew a
documentary was in the works, butdidn’t
know that it was about a legal effort against him. According to
his email exchange with Marc Lesser, a producer on the
documentary, Deer was asked multiple times in 2012 to
participate in a documentary about the “MMR scandal”; at that
point, Bailey’s team had already been filming Wakefield for a
year. The exchange ended after Deer accused the filmmakers of
being funded by anti-vaccine activists, a charge they denied.

Bailey claimed that Deer’s accusations made her question his
reliability, and that her team didn’t know yet exactly what the
film was going to be about beyond the “MMR scandal” when she
contacted Deer. They did not reach out to Deer again.

Deer contacted Bailey and Gravitas Ventures, the distributor of
the documentary, last week, writing in a lengthy letter:“It
appears to me that collectively you have, with this project,
lied, lied, and lied again.” Bailey published the entirety of Deer’s
letter on her website, along with the production team’s entire
correspondence with Deer, after speaking with Jezebel.

“At a time when ‘fake news’ and a rising culture of deception
are matters of intense debate, it may be that you provide a
case study of how the public can be effortlessly tricked,” Deer
wrote. “In this instance, of course, your victims include
parents of children with disabilities who, thanks to your hero
Wakefield, blame themselves for vaccinating a son or daughter.”

In a second letter to Gravitas Ventures, Deer suggested he
might pursue legal action, and claimed that he was concerned
for his safety. Gravitas has not responded to multiple requests
for comment from Jezebel.

When I asked if they’d reached out to anyone else who could
provide a counter-argument to various things Wakefield and
others say throughout the film, Bailey argued that the style of
the documentary, which she compared in an email to cinéma
vérité, would make that difficult to weave in.

“Once the style of the film found itself, which was not the
style of, you know, a news show—once it was clear that it was a
character study about this figure in history, then it felt
like, when you’d have those things, they weren’t attached to
the character study and it seemed like a messy concept,” Bailey
told me.

“I’m not a newsperson, I’m not there to show a balanced—I’m not
Fox News, I don’t need to do interviews. Interviews are boring,
also.”

In the email, she added:

“I gather that your question to me is really wanting me to
answer why I didn’t show interviews of other people who can
tell me that Wakefield is a fraud, and a charlatan etc. Well,
that information is already out there. It’s in every piece of
news we read about him. If you are familiar with the story
you already know all of that. I wanted to show you what you
haven’t seen which is inside his life living with these
charges.”

The expectation that a viewer would come to the documentary
with extensive foreknowledge isn’t really a fair one, or one
likely to result in clarity. But clarity isn’t the goal of this
film. An inaccurate statement by Carmel Wakefield, for
example—that her husband was listed last on the Lancet paper,
that he simply “collated” the findings—was only quietly refuted
several frames later, when his name (listed first) is
underlined on the paper as his lawyer speaks about something
else. Wakefield’s lawyer—rather than a scientist, for
example—explains the Lancet paper’s conclusions to
viewers. Wakefield’s brother provides us with commentary on a
trial.

A mournful, occasionally stirring violin soundtrack plays
through the film as we spin through scenes of Wakefield sitting
on bleachers, doing yoga, worrying about his children,
Wakefield giving a toast to a group of generous chiropractors,
Carmel Wakefield telling her daughter they can’t afford their
house anymore as legal bills mount, Wakefield’s mother telling
him she hopes he is “cleared in the eyes of your peers before
anything happens” to his father, Wakefield chopping wood in a
tank top.

You can refute some of his statements, and question him about
his discrepancies, and show news footage of Anderson Cooper
reaming him on CNN, but the decision to physically focus this
documentary entirely within Andrew Wakefield’s perspective,
giving him and his family an opportunity to repaint himself as
wronged and his research as ethical when there is quite a lot
of evidence to the contrary, is an odd one, given the stakes of
the subject matter. Is it artful to project ambiguity onto a
subject that is, at this point, pretty unambiguous? When the
topic of a documentary involves a basic health decision that
could put a viewer’s kid, or someone else’s kid, in the
hospital, is it responsible to let viewers walk out in a state
of confusion?